Correlates of Intent to Increase Sexual Risk-Taking After HPV Vaccination

Background: Few studies have investigated women's intent to increase sexual risk-taking after completing the 3-dose HPV vaccine series. Methods: After receiving dose 1 of the HPV vaccine for free, 344 Appalachian women (ages 18-26) completed a brief survey. Results: Mean age was 22.0 years (SD=2.4). 45% of the women indicated intent to increase sexual risk-taking. Being married (P=.87), having children (P=.37), and age (P=.31) were not associated with this intent. Intent was higher among those who “worried” about cervical cancer compared to who did not (51.6% vs. 33.3%; P=.01). Among women with friends or family with cervical cancer, 43.0% indicated this intent compared with 28.6% of women without diagnosed friends or family (P=.019). Bisexual women indicated this intent more so than heterosexual women (69.7% vs. 21.6%; P<.0001). Using a 4-item fatalism measure (after performing a median split to dichotomize a skewed distribution), 54% of those scoring high in fatalism stated the intent compared to 36% scoring lower on this measure (P<.001). Women with a history of abnormal Pap results were less likely to indicate this intent compared to those never having this experience (33.1% vs. 53.9%; P<.0001). In a multiple logistic regression model, only two of the five associations retained significance: being bisexual (AOR=5.15, 95% CI=2.00-13.30) and cervical cancer worry (AOR=3.25; 95% CI=1.40-7.83). Conclusion: Intent to increase sexual risk-taking after HPV vaccination was high and did not vary by marital status, having children, or age. Intent was particularly high for bisexual women and those indicating worry about cervical cancer.